Comparative Study Of Carrying Angle Between Dominant And Non-Dominant Limb In Normal Young Girls

Background:The angle subtended by the long axis of the arm and the long axis of forearm in the frontal plane when the elbow is fully extended and the forearm is supinated. Normal degree of Carrying angle is 5 ?-15 ? but in females it is varies on 5 ?-18 ?. The apparent difference in gender may be because of increased joint laxity in females permitting a greater degree of extension. Comparative study of carrying angle between dominant and non-dominant limb in normal young girls. This study aimed comparison of between dominant and non-dominant limb data obtained by clinical method in 18 –20 years normal young girls.Material And Methods:Carrying angle was measured in 141 students of girls in manual method with goniometer.Result:In girls carrying angle dominant limbwas greater than non-dominant limb in girls.Conclusion:The study we conducted there is no significance difference in carrying angle among females in both dominant and non-dominant limb in young girls.

Social support perceived by the older college students compared to the younger ones / Apoio social percebido por estudantes universitários mais velhos comparados aos mais jovens / Apoyo social percibido por estudiantes universitarios mayores en comparación con los más jóvenes

This study was carried out with 326 university students (126 older adults and 200 younger adults) from 13 universities in the state of Rio de Janeiro. It aimed to investigate the importance these older and younger students attributed to the social support, identifying the differences and similarities between them. The students completed a questionnaire that included the Social Support Scale (MOS-SSS), using the Exploratory Graph Analysis - EGA method to demonstrate the dimensionality of this scale in these groups. The results showed that promoting social support in the older adults' network could help improve their functional and educational practice and general development. This knowledge emphasizes and consolidates the role of the university in gerontological education. Social support is important for both age groups, with affective and material dimensions predominant in the older adults. (AU)

Este estudo foi realizado com 326 universitários (126 idosos e 200 jovens) em 13 universidades do Estado do Rio de Janeiro. Objetivou compreender a importância que os estudantes universitários mais velhos e mais jovens atribuíam ao apoio social, identificando as diferenças e semelhanças entre eles. Estes participantes preencheram um questionário que incluiu a Escala de Suporte Social (MOS-SSS), usando o método Exploratory Graph Analysis (EGA) para demonstrar a dimensionalidade dessa escala nesses grupos. Os resultados demonstraram que a promoção do apoio social na rede de idosos pode ajudar a melhorar suas práticas funcionais e educacionais e o desenvolvimento geral. Esse conhecimento enfatiza e consolida o papel da universidade na educação gerontológica. Este estudo demonstrou que o apoio social é importante para as duas faixas etárias, embora as dimensões afetivas e materiais sejam predominantes em relação aos idosos. (AU)

Este estudio se realizó con 326 estudiantes universitarios (126 ancianos y 200 jóvenes) de 13 universidades en el estado de Río de Janeiro. Su objetivo fue comprender la importancia que los estudiantes universitarios mayores y más jóvenes atribuían al apoyo social, identificando las diferencias y similitudes entre ellos. Dichos estudiantes completaron un cuestionario que incluía datos sociodemográficos y la Escala de Apoyo Social (MOS-SSS), utilizando el método Exploratory Graph Analysis (EGA) para demostrar la dimensionalidad de esta escala en estos grupos. Los resultados evidenciaron que la promoción del apoyo social en la red de ancianos puede ayudar a mejorar sus prácticas funcionales y educativas y su desarrollo general. Este dato enfatiza y consolida el papel de la universidad en la educación gerontológica. El estudio demostró que el apoyo social es importante para ambos grupos de edad, aunque las dimensiones afectivas y materiales son predominantes en los estudiantes mayores. (AU)

Colorectal cancer in younger adults (<50 years); a retrospective study on its clinicopathological characteristics

Background:Colorectal cancer (CRC) is a common cancer worldwide with significant geographical variation in its incidence. CRC among young adults is not well reported in Indian patients.Methods:A retrospective study was performed to determine the burden and to analyze the clinicopathological characteristics of newly diagnosed CRC among younger adults(<50 years). Chi-square method was used to analyze the clinicopathological characteristics. P?0.05 was considered statistically significant.Results:CRC among younger adults comprised 40.3% of total patientsmedian age of 40 years at diagnosis, was associated with predominantly male patients with male: female ratio of 1.8:1, positive family history,lesser co-morbidities (p=0.000), majority left sided primary tumor with left: right ratio of 4.6:1, more frequent high grade histologycompared to older age group (p=0.000), advanced primary tumor and nodal metastasis. Approximately one third patients haddistant metastasis at diagnosis compared to in one fourth patients in older patients. Peritoneal metastasis was significantly higher among younger adults compared to older patients (p=0.000). Significantly greater proportion of patients among younger adults initially presented with bowel obstruction (p=0.034), for which upfront emergency surgical procedures was performed in significantly higher proportion of patients compared to the older age group (p=0.007).Conclusions:Advanced stage and aggressive disease biology of CRC in younger adult warrants inclusion of one decade younger age group into present screening recommendation.

Clinical Outcome and Factors Predictive of Outcome of Nasolacrimal Duct Probing for Congenital Nasolacrimal Duct Obstruction in Younger and Older Children Performed at a Regional Institute of Ophthalmology in Western India

2-6 % of full term newborn children manifest symptoms of congenital nasolacrimal duct obstruction. The most frequent presentation is tearing associated with mattering of the eyelashes and recurrent infection. We designed a study to compare the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our western regional institute of ophthalmology. Probing under general anaesthesia was done in a cohort of children presenting with congenital nasolacrimal duct obstruction . The demography ,clinical presentation, management and outcome of the cases were documented. Factors associated with success of the procedure were documented. Aim: The aim of the study was to document the clinical outcome and factors predictive of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our Western Regional Institute of Ophthalmology in India. Methods: The study was carried out at our Western Regional Institute of Ophthalmology. The study period was July 2018 to May 2019 . The study was a prospective interventional outcome study in an institutional cohort. Probing was reserved for patients with recurrent infection or acute dacryocystitis in children between 6 months to 9 months of age . Initial probing was the treatment of choice for children between one year and three years as well as older children above three years upto twelve years. Probing was performed under general anaesthesia. Patients were followed at 1 week, 3 weeks, 3 months and 6 months after the procedure. Outcome was defined as resolution of symptoms and signs of nasolacrimal duct obstruction as observed by the ophthalmologist as well as reported by the parents within 3 weeks of the procedure and continued remission for 6 months post procedure. Probing was done twice before the procedure was declared a failure. Statistical Analysis: Student t test and chi square test was used for statistical analysis . p<0.05 was taken as significant. The Fischer exact test was used to calculate the chi square value. Results: 25 eyes of 18 children with congenital nasolacrimal duct obstruction were subjected to probing during the time of the study. The age range was six months to eleven years. The overall success rate was 16/25(64%). The success rate for children less than or equal to three years was 8/9 (89%).The success rate in the age group three years to less than or equal to seven years was 7/12 (58.3%) . The success rate dropped to 25% (1/4) for children more than seven years of age. The success rate of nasolacrimal duct probing was observed to reduce with increasing age of the child. Persistent dacryocystitis, firm obstruction on nasolacrimal duct probing and repeat probing were statistically significantly associated with the outcome of probing. The children with any of the above factors had a lower success rate of nasolacrimal duct probing. Conclusion: The results of our study are comparable to other studies reporting outcome and predictive factors of nasolacrimal duct probing in younger and older children with congenital nasolacrimal duct obstruction. Children less than or equal to three years of age with congenital nasolacrimal duct obstruction could be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing. Conclusion: Children less than or equal to three years of age with congenital nasolacrimal duct obstruction can be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. Thus in the light of the fact that probing is a safe and effective procedure , it appears logical to give a trial of initial nasolacrimal duct probing even to children older than three years. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing.

Specifics of psychological and pedagogic correction of deviani behavior in younger adolescents with intellectual disability

Problem and aim. Deviant behavior is not only an alarming phenomenon but also a multitude of social, pedagogic and psychological problems that threaten the society and that became particularly relevant for the young adolescents with intellectual disability. Therefore, the aim of the present article is to reveal the specifics of correctional and developmental work with such children that would provide appropriate interpersonal interaction in the adolescence and the further positive socialization. Methods. The presented study was conducted in three stages (exploratory-preparatory, experimental and control-generalizing stages) with the use of the Buss-Durkee Hostility Inventory. Results and discussion. The results showed that the predominant from of the deviant behavior was hostility and violence, as well as a tendency for addictive behavior. Diagnostics of the dominant indices of hostility and aggressiveness demonstrated that the aggressiveness index dominated in the majority of adolescents. The majority of adolescents had a very high or high level of indirect hostility and assault, along with suspicion. The correctional program provides correctional effect for the adolescents with low and medium level of proneness to the deviant behavior

Application status of HPV vaccine in China / 中国实用妇科与产科杂志

The coverage rate of HPV vaccination in China is still very low,and the main reason may be related to people's confusion about the choice of vaccine types,the best age of vaccination,vaccination procedures and prices and other factors.This paper briefly describes the etiology of cervical cancer,the approval of HPV vaccine,the application status of HPV vaccine in foreign countries,and the current situation and challenges in the use of cervical cancer vaccine in China,and advocates that obstetrics and gynaecology experts/disease control experts actively promote the prevention and control of cervical cancer,so that young girls and their parents understand the knowledge related to cervical cancer and HPV vaccine,and young girls can be vaccinated with HPV vaccine as early as possible,so as to improve the coverage rate of HPV vaccination and eliminate cervical cancer.

Long-Term Clinical Results of Unicompartmental Knee Arthroplasty in Patients Younger than 60 Years of Age: Minimum 10-Year Follow-up

PURPOSE: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in patients younger than 60 years of age. MATERIALS AND METHODS: One hundred and six cases of medial UKA with a minimum follow-up of 10 years were selected for this study. There were 80 patients and the preoperative diagnosis was osteoarthritis in all cases. The mean age of the patients was 54.2 years and the mean duration of follow-up was 12.1 years. Clinical assessments were performed using the Knee Society clinical rating system, and a survival analysis was performed using the Kaplan-Meier method. RESULTS: The mean knee and function scores improved from 52.8±8.4 points and 56.6±10.6 points preoperatively to 85.4±9.1 points and 84.7±10.4 points at the last follow-up, respectively (p < 0.001). The mean range of motion was recovered from 130.7° to 132.8° at the last follow-up. Complications occurred in 20 cases (16.7%) and the most prevalent complication was mobile bearing dislocation (n=9, 7.5%). The 10-year survival rate was 92.8% when conversion to total knee arthroplasty was defined as failure, whereas 89.3% when failure was defined as all revision surgeries. CONCLUSIONS: The long-term clinical results of UKA were satisfactory in patients under 60 years of age. Therefore, UKA could be a useful method for the treatment of medial compartment osteoarthritis of the knee in patients younger than 60 years of age.

Apendicitis en menores de cinco años en el Hospital Provincial General Docente de Riobamba / Appendicitis in children under five years old of age in the Hospital Provincial General Docente de Riobamba

La apendicitis en menores de cinco años es rara y un reto diagnóstico. El diagnóstico de apendicitis se ve limitado por la anamnesis y la poca colaboración del examen físico en este grupo etario de pacientes. El objetivo del presente trabajo fue revisar la casuística de apendicitis en menores de cinco años en el Hospital Provincial General Docente de Riobamba (HPGDR) entre el 2012 y el 2016. Con este objetivo se realizó un estudio retrospectivo, de corte transversal en niños operados de apendicitis. En el total de los casos se analizaron los síntomas, signos, pruebas de laboratorio, exámenes histopatológicos y de imagen. El porcentaje de apendicitis en menores de 5 años fue de 11 casos (3 %) de un total de 412 casos de apendicitis operadas en menores de 15 años. En el 100% de los casos (n = 11) el dolor abdominal difuso fue el síntoma más frecuente; además se evidenció leucocitos en 10 casos (91 %). Nueve de los 11 casos (82 %) fueron apendicitis complicadas (grado III y IV) y dos (18 %) no complicadas. La mayor estancia hospitalaria fue de 13 días y en ninguno de los casos se requirió una nueva intervención. El diagnóstico y tratamiento oportuno de apendicitis en menores de cinco años sigue siendo un reto. Es importante mantener un alto grado de sospecha en el caso de de que el diagnóstico sea incierto.

Appendicitis in children younger than five years is old is a diagnostic challenge. Diagnosis of appendicitis is limited by the anamnesis and little cooperation during physical examination of pediatric patients. The objective of the present work was to check the casuistry of appendicitis among children younger than five years old in the Hospital Provincial General Docente de Riobamba (HPGDR) between 2012 to 2016. In this way, we carried out a cross­sectional, retrospective study in all children diagnosed with appendicitis (11 cases in total). In all cases we analyzed symptoms, signs, histopathological and imaging studies. The percentage of appendicitis in children under five years old corresponded to 3 % (n = 11) of a total of 412 cases of appendicitis that required surgery in children younger than 15 years old. In 100 % of the cases (n = 11) diffuse abdominal pain was the most frequent symptom; additionally leukocytosis was noted in 91 % of the cases (n = 10). Nine of the 11 cases (82 %) were complicated appendicitis (grade III and IV) and two (18 %) were not complicated. The longest patients stay lasted 13 days and none of the cases required a a new intervention. The diagnosis and opportune treatment of this pathology in children younger than five years old continues to be a challenge. It is important to maintain a high degree of suspicion in case of uncertain diagnosis.

A Importância da intergeracionalidade para o desenvolvimento de universitários mais velhos / The importance of intergenerationality to the development of older university students / La importancia de la intergeneracionalidad al desarrollo de los estudiantes universitarios de más edad

O envelhecimento tornou-se preocupação de diversas áreas do conhecimento, dentre elas o ensino-aprendizagem, com foco nas relações intergeracionais. Contudo, há uma carência de pesquisas que demonstrem os benefícios desta intergeracionalidade na educação universitária. Este trabalho teve por objetivo verificar a importância da intergeracionalidade no desenvolvimento dos estudantes mais velhos. A pesquisa teve abordagem qualitativa, por meio de entrevistas semiestruturadas e utilização da análise de conteúdo, baseadas na percepção de diferentes atores acerca da sabedoria, suporte social, habilidades sociais, superação (atitudes resilientes) e o contato intergeracional. Participaram desta pesquisa 20 universitários (10 mais jovens e 10 mais velhos), três professores e dois funcionários de duas universidades do Rio de Janeiro. O contato intergeracional percebido é benéfico aos universitários, independentemente da idade, especialmente para os mais velhos, tanto para o seu desenvolvimento pessoal quanto para o desempenho acadêmico. A idade não é critério definidor do envelhecimento, nem na percepção dos universitários mais velhos, nem na dos mais jovens. As diferenças entre estudantes mais jovens e mais velhos, via de regra, são superadas ao longo do tempo. São recomendadas pesquisas sobre as habilidades sociais, especialmente as desenvolvidas no âmbito acadêmico, como fator de influência no desempenho dos universitários mais velhos. (AU)

Aging has become a concern in many areas of knowledge, among them the focus on teaching and learning in intergenerational relations. However, there is a lack of research demonstrating the benefits of this intergenerationality in university education. This study aimed to verify the importance of intergenerational development of older students. The research approach was qualitative, through semi-structured interviews and use of content analysis, based on the perception of different actors about wisdom, social support, social skills, resilience (resilient attitudes) and intergenerational contact. The study gathered 20 students (10 younger and 10 older), three teachers and two staff from two universities of Rio de Janeiro. The intergenerational contact perceived is beneficial to the development of the university, regardless of age, but especially for the elderly. The intergenerational relationship is favorable to older students as their personal development and academic performance and age is not a defining criterion of aging on the perception of older and younger students. The differences between younger and older students, as a rule, are overcome over time. Researches on social skills are recommended, especially those developed in the academic, as an influence factor on the performance of older students. (AU)

El envejecimiento se ha convertido en una preocupación en muchas áreas del conocimiento, entre ellos el enfoque en la enseñanza y el aprendizaje en las relaciones intergeneracionales. Sin embargo, hay una falta de investigación que demuestra los beneficios de esta intergeneracionalidad en la educación universitaria. Este estudio tuvo como objetivo verificar la importancia del desarrollo intergeneracional de los estudiantes mayores. El enfoque fue cualitativa, a través de entrevistas y el uso de análisis de contenido semi-estructurados, basado en la percepción de los distintos actores sobre la sabiduría, el apoyo social, las habilidades sociales, la resiliencia (actitudes resilientes) y el contacto intergeneracional. El estudio reunió a 20 estudiantes (10 menores y 10 mayores), tres profesores y dos funcionarios de dos universidades de Río de Janeiro. El contacto intergeneracional percibido es beneficioso para el desarrollo de la universidad, independientemente de su edad, pero especialmente para las personas mayores. La relación intergeneracional es favorable a los estudiantes mayores como su desarrollo personal y el rendimiento académico y la edad no es un criterio de definición de envejecimiento en la percepción de los estudiantes de más edad y más jóvenes. Las diferencias entre los estudiantes más jóvenes y de mayor edad, por regla general, se superan con el tiempo. Se recomienda la investigación en las habilidades sociales, especialmente las desarrolladas en el ámbito académico, como un factor de influencia en el rendimiento de los estudiantes mayores. (AU)

Aislamientos invasivos de Haemophilus influenzae en menores de 5 años: distribución de los serotipos y de la sensibilidad antimicrobiana, SIREVA II Colombia 2002-2013 / Invasive Haemophilus influenzae isolates in children younger than 5 years: Distribution of serotypes and antimicrobial sensitivity, SIREVA II Colombia 2002-2013

Objetivo: Analizar del 2002 al 2013 los datos de la vigilancia de los serotipos y sensibilidad antimicrobiana de los aislamientos invasivos de Haemophilus influenzae ( H. influenzae ) en niños menores de 60 meses. Materiales y métodos: Se analizaron los datos demográficos, fuente y enfermedad asociada de los aislamientos invasivos de H. influenzae recibidos entre 2002 y 2013. Todos los aislamientos habían sido confirmados bacteriológicamente, tenían el dato del serotipo, el cual fue determinado por el método de aglutinación en lámina y PCR y los patrones de sensibilidad antimicrobiana por concentración inhibitoria mínima a ampicilina, SXT, cloranfenicol, cefuroxima y ceftriaxona. El análisis se realizó por periodos de 3 años. Resultados: Por enfermedad invasiva el 50,5% eran de pacientes con meningitis, 23,5% de neumonías, 19,5% de sepsis y bacteriemia, 2,0% de otros y 4,5% sin dato. Por procedencia se recibieron de Bogotá y Antioquia 55 aislamientos de cada uno, de Risaralda 24, de Valle 15, de Santander 11 y 40 de 14 departamentos. El serotipo predominante fue el Hib (40,5%), seguido de HiNT (38,0%), Hia (17,5%), Hid (2,0%), Hif (1,5%) y Hie (0,5%). Del total de los aislamientos, 12,0% eran resistentes a ampicilina; 16,5% a SXT; 1,0% a cloranfenicol y 0,5% a ceftriaxona. Todos los aislamientos fueron sensibles a cefuroxima y a rifampicina. Conclusiones: La vigilancia por el laboratorio es una vigilancia pasiva voluntaria pero, no obstante el número reducido de aislamientos, permite determinar que Hib continúa circulando en esta población y que hay otros serotipos de H. influenzae que causan enfermedad invasiva. Por tanto es necesario mantener y fortalecer la vigilancia de este patógeno.

Objective: To analyze 2002-2013 surveillance data on the serotypes and antimicrobial sensitivity of invasive Haemophilus influenzae ( H. influenzae ) isolates in children younger than 60 months. Materials and methods: We analyzed the demographic data, source and associated diseases ofinvasive HI isolates from cases recorded from 2002-2013. All isolates had been bacteriologically confirmed and had data on their serotype, which was determined by the slide agglutination method and polymerase chain reaction. The antimicrobial sensitivity patterns were determined by minimum inhibitory concentration of ampicillin, trimethoprim-sulfamethoxazole, chloramp-henicol, cefuroxime and ceftriaxone. The analysis was conducted in 3-year periods. Results: According to invasive disease, 50.5% of patients had meningitis, 23.5% had pneumonia,19.5% had sepsis and bacteremia, 2.0% had other diseases and 4.5% lacked data. By origin, 55 isolates each were received from Bogota and Antioquia, 24 were from Risaralda, 15 were from Valle, 11 were from Santander and 40 came from 14 departments. The predominant serotype was Hib (40.5%), followed by HiNT (38.0%), Hia (17.5%), Hid (2.0%), Hif (1.5%) and Hie (0.5%). Ofthe total isolates, 12.0% were resistant to ampicillin; 16.5% to trimethoprim-sulfamethoxazole,1.0% to chloramphenicol and 0.5% to ceftriaxone. All isolates were sensitive to cefuroxime andrifampicin. Conclusions: Laboratory surveillance is a voluntary passive surveillance; however, the low number of isolates helped determine that Hib continues to circulate in this population and that there are other H. influenzae serotypes that cause invasive disease. Therefore, surveillance of this pathogen needs to be maintained and reinforced.

Effect of Short-Term Partial Enteral Nutrition on the Treatment of Younger Patients with Severe Crohn's Disease

BACKGROUND/AIMS: To analyze the effect of short-term supportive temporary partial enteral nutrition therapy for treating severe pediatric Crohn's disease (CD). METHODS: We conducted a prospective, open-label study in pediatric patients with CD (n=78) from January 2007 to December 2011. The CD patients were divided into three groups according to disease severity (mild, moderate, and severe). Seventeen patients with severe CD received short-term partial enteral nutrition (SPEN) in addition to their general diet for 4 weeks after the induction of remission with medical treatment. This SPEN group was further divided into two groups by age ( or =13 years). Nutritional parameters and Pediatric Crohn's Disease Activity Index scores were analyzed at the initial enrollment and following 1 year of treatment for all groups. RESULTS: Nutritional status improved substantially after 1 year of treatment in the severe CD group. Nutritional status in the SPEN group improved considerably more than that in the non-SPEN group. Additionally, the or =13-year-old group. CONCLUSIONS: SPEN may be effective in pediatric patients with severe CD for improving nutritional status and moderating disease severity.

Tuberculosis en menores de 15 años / Tuberculosis in children younger than 15 years

Introducción: La Habana es la provincia con mayor incidencia de tuberculosis infantil en Cuba. Objetivo: caracterizar la tuberculosis infantil en La Habana. Métodos: se realizó un estudio descriptivo, transversal, en el universo de enfermos menores de 15 años, en el período 2001-2010. De las encuestas epidemiológicas se revisaron: variables demográficas, localización, forma clínica y datos que condujeron al diagnóstico. Resultados: se reportó una incidencia de 44 casos, y tasas al inicio y final de 2,2 y 2,1 x 100 mil habitantes de 0-14 años respectivamente. Exceptuando los años 2003 y 2006, las tasas de La Habana estuvieron muy por encima de la media nacional, al igual que el porcentaje de casos infantiles en relación con el total de enfermos. Predominaron los menores de 5 años; no se reportaron lactantes. El sexo femenino (54,5 por ciento) fue el más afectado en general, aunque predominó el sexo masculino en los menores de 5 años. Los municipios más afectados fueron: Cerro y Arroyo Naranjo (7 y 5 casos respectivamente), seguidos por Centro Habana, Plaza, Marianao y 10 de Octubre con 4. Predominó la localización pulmonar (38-86,4 por ciento), fundamentalmente formas primarias, con 15,8 por ciento de baciloscopias positivas, todas en formas pulmonares tipo adulto. El resultado de la prueba de Mantoux fue ³ 10 mm en 68,2 por ciento. Se identificó el contacto infectante en el 88 por ciento, sobre todo, los menores de 5 años, que se infectaron con más frecuencia en el hogar. Conclusiones: aunque La Habana tiene condiciones demográficas que favorecen la transmisión, hay que profundizar en la pesquisa activa en los controles de foco, y a otros grupos más vulnerables para contribuir a la eliminación de la TB

Introduction: Havana is the province with the highest t incidence of infant tuberculosis in Cuba. Objective: to characterize infant tuberculosis in Havana. Methods: a cross-sectional descriptive study was performed in patients younger than 5 years in the period of 2001 through 2010. Some variables were checked in the epidemiological surveys such as demographic variables, location, clinical form and data, which led to the diagnosis. Results: there were reported an incidence of 44 cases, and initial and final rates of 2.2 and 2.1 per 100 000 inhabitants aged 0-14 years, respectively. Except for the years 2003 and 2006, the rates of Havana province were well over the domestic mean as it was the case of the percentage of infant cases with respect to the total number of patients. Children younger than 5 years prevailed; no nurslings were reported. Females (54.5 percent) were the most affected in general, although males predominated in children under-5 years of age. The most affected municipalities were Cerro and Arroyo Naranjo (7 and 5 cases, respectively) followed by Centro Habana, Plaza, Marianao and 10 de Octubre with 4 each. Pulmonary location predominated (38-86.4 percent), mainly the primary form, with 15.8 percent positive bacilloscopies, all in adult-type pulmonary forms. The result of Mantoux's test was ³ 10 mm in 68.2 percent. The infective contact was identified in 88 percent of cases, mainly in children aged less than 5 years, who got infected more frequently at home. Conclusions: although Havana province has demographic conditions that favor disease transmission, one must perform more thorough active screening to control foci, and for other more vulnerable groups to contribute to eliminate tuberculosis

Causes of Failure after Total Knee Arthroplasty in Osteoarthritis Patients 55 Years of Age or Younger

PURPOSE: To identify the modes of failure after total knee arthroplasty (TKA) in patients >55 years of age and to compare with those >55 years of age in patients who underwent revision TKA. MATERIALS AND METHODS: We retrospectively reviewed 256 revision TKAs among patients who underwent TKA for knee osteoarthritis between January 1992 and December 2012. The causes of TKA failure were analyzed and compared between the groups. RESULTS: Thirty-one revision TKAs were performed in patients 55 years of age at primary TKA. In the < or =55 years of age group, the most common cause of TKA failure was polyethylene wear (45%) followed by infection (26%) and loosening (17%). The interval from primary TKA to revision was 8.6 years (range, 1 to 17 years). There were relatively lower infection rate and higher loosening rate in patients < or =55 years of age, but the difference was not statistically significant. CONCLUSIONS: The main causes of failure after TKA in patients < or =55 years of age were polyethylene wear, infection and loosening, and there was no significant difference in the modes of failure after TKA between the two groups.

Diagnóstico educativo sobre salud bucal en embarazadas y madres con niños menores de un año / Educational diagnosis on oral health for pregnant women and mothers with children younger than one year

La atención estomatológica en Cuba prioriza a embarazadas y madres con niños menores de un año. Objetivo: identificar los conocimientos sobre salud bucal de embarazadas y madres con niños menores de un año. Métodos: se realizó un estudio observacional, descriptivo y transversal, en el municipio Matanzas de 2010 a 2012. El universo fueron todas las embarazadas y madres con niños menores de un año. Se seleccionó una muestra no probabilística con las primeras 126 gestantes captadas y 126 madres que acudieran a puericultura, que dieron su consentimiento informado. Se aplicó la encuesta de conocimientos del Programa Nacional de Atención Estomatológica Integral a la Población y una lluvia de ideas para identificar los conocimientos favorables o no a la salud bucal, en relación a cuatro temas: caries dental, periodontopatías, brote dentario y maloclusiones. Se consideró el nivel de conocimientos bajo (menos de 70 puntos), medio (entre 71 y 89 puntos) y alto (más de 90 puntos). Los datos obtenidos fueron procesados estadísticamente, se usó el porcentaje como medida de resumen. Resultados: entre los conocimientos favorables a la salud bucal estuvieron los relacionados con las medidas preventivas de caries dental y periodontopatías, como el cepillado, con 85,7 por ciento en embarazadas y 95,2 por ciento en madres con niños menores de un año. Los conocimientos desfavorables fueron los relacionados con el brote dentario con 96 por ciento en embarazadas y 94,4 por ciento en madres con niños menores de un año. Las madres con niños menores de un año, mostraron nivel de conocimientos medio (70,6 por ciento), mientras que las embarazadas, mostraron nivel bajo (65,9 por ciento). Conclusiones: las madres con niños menores de un año mostraron nivel de conocimientos sobre salud bucal, medio y las embarazadas mostraron un nivel bajo. Los conocimientos sobre brote dentario y maloclusiones fueron insuficientes, por lo que serán las principales temáticas para desarrollar estrategias de promoción de salud en esta población(AU)

Pregnant women and mothers with children younger than one year are priority for dental care in Cuba. Objective: to identify the knowledge on oral health of pregnant women and mothers with children under one year. Method: an observational, descriptive and transversal study was carried out in Matanzas from 2010 to 2012. All pregnant mothers and children younger than one year were the universe. A nonrandom sample with the first 126 pregnant women and 126 mothers, who had come to childcare, was selected. All of them gave their informed consent. Survey of knowledge of the National Program for Comprehensive Stomatology Care was applied; also a brainstorming was used to identify favorable knowledge on oral health, in relation to four topics: dental caries, periodontal disease, tooth bud and malocclusions. Knowledge level was considered low (less than 70 points), average (between 71 and 89 points) and high (over 90 points). The data obtained were processed statistically; the percentage was used as a summary measure. Results: among the favorable oral health knowledge were preventive measures of dental caries and periodontal diseases, such as brushing: pregnant women 85.7 per cent, and 95.2 percent in mothers with children younger one year. Unfavorable knowledge were related to tooth bud with 96 percent in pregnant women and 94.4 percent in mothers with children younger than one year. Mothers with children younger than one year showed average level of knowledge (70.6 percent), while pregnant women showed low (65.9 per cent) level. Conclusions: mothers with children younger than one year showed average level of knowledge on oral health, and pregnant women showed low level. Knowledge of tooth bud, and malocclusions were insufficient, so these will be the main topics to develop in health promotion strategies for this population(AU)

Family factors in developmental delays in children under six years old

Development delay in children under 6 years old is prevalent not only in both developed and developing countries. It is alarming that the number of delayed children is increasing. It is obliging to find out the family factors that possibly affect developmental delays in children six years old and younger. The objectives of the study were the following: (1) Describe the characteristics of families of children with developmental delays. (2) Determine the factors that significantly relate with developmental delays when comparing families of children, with delays and without delays. The sample was composed of 52 delayed children and their families, and 52 normal children and their families who were purposively chosen. The data was collected from March to May 2011 with the approval of the Saint Louis University Research Ethics Committee. The Metro Manila Developmental Screening Test was used  to test child development. The Parent Behavior Checklist was used to assess  parenting behavior of mothers. A questionnaire was used to collect family and child factors. The results of analysis revealed that higher frequencies of delays occurred in children one (23.08%) and three (23.08%) years of age; first born or only child (36.54%), and in households with three children or less (32.69%). Families of delayed children are of low socio-economic status, whose mother predominantly scored low in all categories of parenting. It was also found out that more frequencies  of delays occurred in the fine motor adaptive sector (86.54%), followed by the language (69.23%), gross motor (38.46%) and personal-social (32.69%) sectors respectively. Results of the chi square test revealed that expectation parenting behavior is significantly associated to developmental delay in the gross-motor sector (p 0.005) in children under six years of age. Developmental delays in the gross motor sector in the three to less than six-year-olds are significantly associated with father's occupation (p 0.009) and expectation parenting behavior (p 0.022). Analysis of factors associated with developmental delays when comparing delayed and normal children revealed that family factors are not significantly associated with developmental delays. A sub-analysis of age groups however revealed that mother's occupation and developmental delays are significantly associated in the three to less that six-year-old age group (p 0.026). It is concluded that children with developmental delays belong to families with disadvantaged socioeconomic status whose mothers scored low in all subscales of parenting behaviors; and family characteristics, parenting behaviors of the mother and child characteristics are not significantly related to developmental delays  in children under six years old. Therefore, health workers should be more vigilant in identifying children with developmental delays regardless of family characteristics.

Infarto agudo al miocardio en pacientes menores de 40 años: características clínicas, angiográficas y alternativas terapéuticas / Acute myocardial infarction in patients under 40 years of age: clinical and angiographic characteristics: therapeutic options

Objetivos: Analizar comparativamente las características clínicas y angiográficas, y el tratamiento utilizado, en pacientes jóvenes cursando un infarto agudo del miocardio (IAM) con supradesnivel del segmento ST (SDST). Métodos: Análisis retrospectivo de los pacientes que se presentaron con un IAM con SDST y fueron sometidos a angiografía coronaria durante el período entre enero de 2009 y diciembre de 2011. Se identificó a los pacientes menores de 40 años y se registraron sus características clínicas y angiográficas, las terapias utilizadas y sus resultados a mediano plazo. Estos datos fueron comparados con los pacientes de 40 o más años atendidos durante el mismo período. Resultados: De 613 IAM con SDST, 40 (6,5 por ciento) casos correspondieron a menores de 40 años (edad promedio 36,6 años). De éstos, 7 (17,5 por ciento) fueron mujeres, 32 (80 por ciento) fumadores y 17 (42,5 por ciento) referían uso de cocaína. La mayoría presentó alta carga trombótica (TIMI Thrombus Grade 4/5 en 87,5 por ciento), pero con enfermedad de baja severidad anatómica (Syntax Score promedio 13,1 (DE 5,8)). Treinta (75 por ciento) pacientes recibieron an-gioplastía con stent y 21 (52,5por ciento) aspiración de trombos. El seguimiento tardío reveló 5 (12,5 por ciento) eventos mayores. Comparado con los pacientes mayores de 40 años, la mortalidad al año fue marcadamente inferior: 2,5 por ciento versus 12 por ciento, p<0,01. Conclusiones: En menores de 40 años con IAM con SDST, el tabaquismo, uso de cocaína, fueron los principales factores asociados. Aunque la enfermedad coronaria anatómica no fue severa, hubo una gran carga trombótica en la mayoría de los pacientes. Esto se asoció a escasos eventos cardiovasculares y una mortalidad menor a la de los pacientes mayores.

Aim: To analyze clinical and angiographic characteristics and the treatment provided to young patients admitted with an ST-elevation myocardial infarction (STEMI). Methods: Retrospective analysis of patients with STEMI who were invasively studied from January 2009 through December 2011. Clinical and angiogra-phic data, as well as phone follow-ups and mortality registries were reviewed for each patient younger than 40 years old. These results were compared with those from STEMI patients who had 40 or more years of age during the same time period. Results: From 613 STEMI patients, 40 (6.5 percent) had less than 40 years (average age 36.6 years). Among these, 7 (17.5 percent) were females, 32 (80 percent) were active smokers and 17 (42.5 percent) recognized cocaine abuse. Whereas most patients presented with high thrombus content (TIMI Thrombus Grade 4/5 in 87.5 percent), the burden of atherosclerotic coronary disease was markedly low (average Syntax Score 13.1 (SD 5.8)). Coronary stents were used in 30 (75 percent) patients and thrombus aspiration in 21 (52.5 per cent). Late follow-up showed 5 (12.5 percent) major cardiovascular events. In comparison with older patients, 1-year mortality was significantly lower for young patients: 2.5 percent versus 12 per cent, p<0.01. Conclusions: Younger patients with STEMI frequently smoke and use cocaine. Although the burden of coronary disease was low, most patients had a high thrombus content. Cardiovascular events and mortality were lower compared to older patients.

Conducta de Infecciones Respiratorias Agudas con/sin Neumonías en menores de 5 años del Centro de Salud "San Benito", Abril-Junio del 2010 / Conduct of acute respiratory infections with/without Pneumonia, 5 years in "San Benito" health center, april-june 2010

Se asume como Infección Respiratoria Aguda al conjunto de infecciones del aparato respiratorio causadas por microorganismos, con evolución menor a 15 días, donde la forma más común de presentacion es la Rinofaringitis Aguda Catarral; con la presencia de signos clínicos, los cuales pueden estar o no acompañados de fiebre y que en ocasiones se complican con neumonía. El objetivo del presente trabajo es determinar cuál es la prevalencia y terapéutica de infecciones respiratorias agudas con o sin neumonías en niños menores de 5 años que acudieron por consulta externa en el Centro de Salud San Benito. Es un estudio descriptivo transversal, se incluyó a todos los niños (500 niños) con diagnóstico de infección respiratoria aguda, menores de 5 años, pesquisados en la gestión 2010 del 1 de abril al 30 de junio. Según los resultados, en la distribución por sexo se muestra una mayor población infantil masculina afectada, con 260 (58.8%) en relación a la femenina con 240 (41.2 %). Del total de los 500 niños con Infecciones respiratorias agudas, 450 (95.3 %) se diagnosticaron como IRA sin neumonía y solamente 25 casos (4.7 %) como IRA con neumonía. En conclusión la prevalencia de las IRA fue de un 36,4 %; la mitad de los casos de IRA ocurrió en el grupo de los RN a 3 años, lo que nos indica la gran necesidad de realizar investigaciones futuras que hagan un seguimiento continuo de la morbilidad e intervenciones que se traduzcan por una disminución de la mortalidad infantil por estas causas.

Is assumed as Acute Respiratory Infection all respiratory tract infections caused by microorganisms with less than 15 days evolution, where the most common presentation is the acute catarrhal Rhinopharyngitis with the presence of one or more symptoms or clinical signs, which may or may not be accompanied by fever and sometimes complicated with pneumonia. This study aims to determine the prevalence and treatment of acute respiratory infections with or without pneumonia in children under 5 years who carne for outpatient Health Center in San Benito. It is a transversal descriptive study, included all children (500 children) with a diagnosis of acute respiratory infection, researched children under 5 years, in the management 2010 fromApril I to june 30.According to the results, the distribution by sex shows a larger male child population affected, with 260 (58.8%) in relation to the female with 240 (41.2%). Of the total of 500 children with acute respiratory infections, 450 (95.3%) were diagnosed as IRA without pneumonia and only 25 cases (4.7%) such IRA with pneumonia. In conclusión the prevalence of IRA was 36.4%; half of IRA cases oceurred in the group of the RN to 3 years, which indicates the great need for further research to make a continuous monitoring of morbidity and interventions that are translated by a decrease in child mortality due to these causes.

Estancia hospitalaria y mortalidad en adultos mayores hospitalizados en un hospital general de Lima Metropolitana, 1997-2008 / Hospital stay and mortality of patients older hospitalized in a general hospital of Lima Metropolitana, 1997 to 2008

Objetivos: Determinar la mortalidad y la estancia hospitalaria de los pacientes adultos mayores hospitalizados en un hospital general de Lima Metropolitana en el periodo 1997 a 2008. Material y Métodos: Estudio descriptivo, retrospectivo de los egresos hospitalarios de pacientes mayores de 14 años de edad, obtenidos de la base de datos del Departamento de Estadística del hospital en dicho periodo. Resultados: En el período de 1997 a 2008 fueron hospitalizados 27 152 pacientes, el 53,66% fueron del sexo masculino. El 38,61% fue del grupo >60 años. La estancia hospitalaria en el grupo menor de 60 años fue 14,84 días y en el grupo >60 años 13,63 días (p<0.05). La mortalidad hospitalaria en los menores de 60 años fue 9,6% y 14,3% en el grupo >60 años, (p<0.05), en el subgrupo de 60 a 79 años fue 12,9%, mientras que en el grupo >80 años la mortalidad fue 17,6%. Los varones tuvieron mayor mortalidad que las mujeres, (58,53 % vs 41,47%)( p<0.05). Se observó un incremento en la hospitalización de la población mayor de 60 años en 19%, mientras que en los pacientes menores de 60 años hubo una reducción del 10%. Conclusiones: La mortalidad fue significativamente mayor en el grupo >60 años y en el subgrupo >80 años.

Objectives: To determine mortality and hospital stay of patients older than 60 years hospitalized in a general hospital of Lima in the period 1997 to 2008. Material and Methods: Descriptive and retrospective study of patients over age 14, with information obtained from the discharges database of the hospital statistics office. Results: In the 1997 to 2008 period, 27 152 patients aged 14 and over were hospitalized, 53.66% were male. The 38.61% were >60 years. The hospital stay in < 60 year group was 14.84 days, and 13.63 days, in >60 year group (p <0.05). Hospital mortality in under 60 years was 9.6% and 14.3% for >60 years, (p <0.05); in the subgroup 60 to 79 years was 12.9%, while in patients >80 years was 17.6%. Males had higher mortality than women, (58.53% vs 41.47%) (p < 0.05). We observed to increase of the population over 60 years in 19%, while than in patients younger than 60 years there was a reduction of 10%. Conclusions: Mortality was significantly higher in the group >60 years and in the subgroup >80 years.

Non-Dura Based Intaspinal Clear Cell Meningioma

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.